Dan Boyle (Green Party)
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I thank the Cathaoirleach. I thank also the Minister of State for being present to take this Adjournment matter on behalf of the Government. The issue concerns health policy on the pre-treatment of children and aftercare, with particular reference to childhood diabetes.

The first issue relating to pre-treatment concerns a vaccination programme and what seems to be an uneven spread of take-up throughout the country due to decisions made about resources. While I realise that decisions on resources and administration are matters for the Health Service Executive, I am enquiring whether there is a policy that certain types of vaccination would be available regardless of geographic location and, in particular, would be available to children and parents of children in specific cases. It was decided in Cork that BCG vaccinations would not be made available. While the cost, €40,000, was quite low for the number of children involved it seems curious that an administrative decision, with consequences for health policy in general, can be made in one part of the country while the parents and children could have access to that vaccination elsewhere. In raising this Adjournment matter I am attempting to find out why that is the case. If the Minister of State is unable to provide a direct answer now I would appreciate if an official of the Department of Health and Children could forward the information. There are tremendous strains on the health service in respect of frontline services but the point I raise today is that if we are clear about policy and put resources into preventative health care and continuing care outside hospital services, we could save much of the current grief about the bottleneck where health service resources are provided.

The treatment of childhood diabetes in the Cork area is of constant concern. The backup team available to children and parents is small compared to services provided elsewhere in the country. There is nothing like the number of doctors, nurses and physiotherapists available in other areas. The former southern health board area, comprising Cork and Kerry, appears to have a preponderance of children suffering from type 1 diabetes. People are born with this rather than acquiring it. I would have thought a national health service, such as the title of the HSE implies, could identify these clusters and allocate resources appropriately. The role of the Department of Health and Children should ensure equality of access to service throughout the country.

It is hard to understand why these difficulties exist in Cork, the second city in Ireland. It should not have them, and they are even more prevalent in isolated, rural communities. That these problems exist at all in a major urban centre is a cause for concern. I wish to put these concerns on record and pose a number of questions, to which I expect a detailed response. By taking the opportunity to make these concerns known I hope to see a process set up to provide effective answers and action in these areas.

Tom Kitt (Dublin South, Fianna Fail)
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I will respond to this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. This provides me with an opportunity to outline to this House the importance attached by the Department of Health and Children and the Health Service Executive to the issues raised.

Immunisation is a simple, safe and effective way of protecting children against certain diseases. The primary childhood immunisation programme is administered on a countrywide basis and is offered to all children in all HSE areas. It is administered by general practitioners. It is a voluntary programme and therefore it is essential that we encourage all parents to have their children immunised against the diseases covered by the childhood immunisation programme in order to ensure that both their children and the population generally have maximum protection against the diseases concerned.

I understand from the HSE that owing to regulatory difficulties being experienced by the manufacturer of the BCG vaccine, there may be a shortage of the vaccine throughout the country during the coming weeks. This is a Europe-wide problem as the manufacturer in question is the only company which supplies the vaccine to the European market. The HSE is in regular contact with the supplier, and is doing all it can do to ensure delivery of the vaccine at the earliest possible juncture. Unfortunately, it is not possible to stockpile the vaccine in advance because it has a very short shelf life. It is anticipated that the HSE will receive fresh stocks of the vaccine in early January.

The objective of the primary childhood immunisation programme is to achieve an uptake level of 95%, which is the rate required to provide population immunity and to protect children and the population generally from the potentially serious diseases concerned. Ireland's recommended immunisation programme is based on the guidelines of the national immunisation advisory committee of the Royal College of Physicians of Ireland. These guidelines are prepared with the assistance of a committee from associated disciplines in paediatrics, infectious diseases, general practice and public health. The recommended childhood immunisation schedule in this country contains immunisation against ten infectious diseases. These include tuberculosis, diphtheria, tetanus, whooping cough, polio, haemophilus influenzae B, meningococcal C disease, measles, mumps and rubella. The national immunisation advisory committee has recently completed a review of our immunisation schedule and among the changes recommended are the addition of hepatitis B and pneumococcal conjugate vaccines to the programme. It is proposed to introduce the new schedule in 2008.

Immunisation against infectious disease has saved more lives than any other public health intervention, apart from providing clean water. In order to eliminate these infectious diseases entirely, uptake of immunisation of 95% or greater is required. When immunisation uptake rates are below 95%, outbreaks of infectious disease will continue to occur and some children will suffer complications or die as a result. Unfortunately, immunisation uptake in this country has never achieved the target of 95%. The HSE informs me that an expert advisory group is examining a policy document on diabetes and this includes issues of childhood diabetes and equality of access.